Individual
MRS. JACQUELINE LEE DESTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
221 PENN AVE, WILKINSBURG, PA 15221-2118
(412) 865-6589
Mailing address
240 WOODSIDE RD, PITTSBURGH, PA 15221-3638
(412) 247-1704
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
UP001881D
PA
Other
Enumeration date
01/30/2007
Last updated
07/15/2013
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